Individual
MISS SHAENA MARIE PETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
100 PARK PL, SELMA, AL 36701-7743
(334) 872-3471
Mailing address
121 MUD BRIDGE RD, FAYETTEVILLE, GA 30215-5802
(678) 591-3472
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
GA
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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